Provider Demographics
NPI:1497932362
Name:ALLERGY AND ASTHMA ASSOCIATES OF VIRGINIA PC
Entity Type:Organization
Organization Name:ALLERGY AND ASTHMA ASSOCIATES OF VIRGINIA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:PENCE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-442-1000
Mailing Address - Street 1:PO BOX 2100
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-9505
Mailing Address - Country:US
Mailing Address - Phone:540-442-1000
Mailing Address - Fax:540-442-1100
Practice Address - Street 1:1967 MEDICAL AVE
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3437
Practice Address - Country:US
Practice Address - Phone:540-442-1000
Practice Address - Fax:540-442-1100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA451662OtherANTHEM OF VIRGINIA